31D2030647 CLIA NUMBER - ROOSEVELT CARE CENTER AT OLD BRIDGE

Laboratory Demographics

  • CLIA Code: 31D2030647
  • Facility Name: ROOSEVELT CARE CENTER AT OLD BRIDGE
  • Facility Address: 1133 MARLBORO ROAD
    OLD BRIDGE, NJ
    ZIP 08857
  • Facility Phone: 732 360-9830
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MARK L. NIEMIERA
  • NPI Number: 1760750053
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 31D2030647
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ROOSEVELT CARE CENTER AT OLD BRIDGE
Street 1133 MARLBORO ROAD
City OLD BRIDGE
State NJ
ZIP 08857
Phone 732 360-9830
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2025
Certificate Expiration Date 10/2/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MARK L. NIEMIERA

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This page was last updated on: 9/29/2025